The East of England Ambulance Service Trust says it has 'robust' measures in place to ensure it is better prepared for the increase in demand this winter.

The ambulance service says it will work closely with its partners in the NHS to keep patients safe.

This includes keeping more ambulances on the road, improving wellbeing among its staff and ensuring a quicker turnaround of patients.

It comes as the trust was the subject of an emergency investigation in January, into whether ambulance delays caused the deaths of patients in the East of England last winter.

In some cases, patients did not get prompt care

Poor provision last winter

Concerns about patient safety were raised after a whistle-blower from the East of England Ambulance Service Trust (EEAST) reported an "usually high number" of potentially serious incidents between December 18 and January 3.

Speaking in Parliament Clive Lewis MP claimed 20 people had died in the East of England after ambulances arrived late over the 12-day period when the service had failed to move into its 'high-priority mode'.

A Government-led 'risk summit' and the trust was ordered to improve its internal escalation procedures to deal with periods of high pressure.

This work will be overseen by a new Regional Tactical Command Cell, which will ensure senior staff are available and on-call 24/7 and can escalate any issues which may arise so that immediate mitigating action can be taken.

It will also monitor hospital turnaround data to give an overview of where capacity is available and act as a single point of contact for all external NHS partners, such as hospitals and commissioners, to improve communication and joint working.

UNISON regional organiser Sam Older said: “Managers at the East of England Ambulance Service may be working hard to prepare for the winter crisis, but the demand on services is likely to be far greater than what either the trust or NHS as a whole can supply.

“Unfortunately we know staff are leaving the employer, in many cases to plug severe shortages in other parts of the NHS. It’s good to see that the new chief executive is taking staff retention seriously, but it can’t be turned round overnight.

“The low staffing also creates problems for ambulance workers’ welfare – the same people are called on to do overtime time and again to keep the service running, with all the extra stress and long hours that entails.

“Other NHS pressures are also felt down the line for ambulance crews. When A&Es are too crowded to accept new patients, ambulances have no choice but to queue up outside until beds become available, taking the vehicle and workers out of action.

“All these pressures stretch the NHS to breaking point in a ‘normal’ winter, but if another Beast from the East batters the region the service will seriously struggle to cope.

“But we’re glad that the trust is preparing for the winter ahead and ambulance staff will be doing everything they can to keep people in the east of England safe while the mercury plummets.”

The plan for the ambulance service

Following the risk summit EEAST were ordered to:

1. Deploy additional staff and vehicles between now and Easter. This will include securing additional vehicles from independent providers

2. Improve its ability to forecast demand as part of strengthened winter planning

3. Take steps to improve staff availability at peak times, including action to improve staff health through flu vaccination and reviewing the Trust’s leave policy

4. Local hospitals will be asked to accept prompt hand-over of patients from ambulance crews in order to release the crews for other calls

5. Improve its internal escalation procedures to deal with periods of high pressure

6. CCGs and other providers of NHS care across the region will implement measures to moderate the use of ambulance services, using safe alternatives wherever possible

7. Any serious incidents that occurred over the winter period will be subject to a thorough review process to ascertain whether patients were harmed.

How EEAST will prepare for winter 2018/19

In response the ambulance trust published its winter preparations in September.

These include:

liaising closely with staff in hospital emergency departments to make sure patients can be handed over quickly and efficiently at hospital

making sure additional capacity is made available to maintain vehicles and minimise any breakdowns or mechanical failures, in turn keeping more ambulances on the road

putting comprehensive staffing, resourcing and management arrangements in place

promoting wellbeing among staff and encouraging uptake of the flu jab to reduce sickness absence

putting specific plans in place for the Christmas and New Year period, including increased clinical support in our control rooms